1. Computational Biomedical Science PREF Outreach Program Dr. Suzanne Shontz Computer Science and Engineering July 8, 2011

2. Today’s Agenda You will learn: about computational science and engineering and computational biomedical science how computational tools can be used to improve treatment of two diseases: deep vein thrombosis and hydrocephalus other areas of engineering where they can be used.

3. Introduction to Computational Biomedical Science

4. Computational Science and Engineering

5. What is Computational Biomedical Science? Computational science and engineering: The application of mathematical and computational techniques to a phenomenon in science or engineering. Biomedical science: The application of the principles of the natural sciences to medicine. Computational biomedical science: The application of mathematical and computational techniques to medicine.

6. Deep Vein Thrombosis

7. Famous People What do these famous people have in common? Serena Williams (US Tennis Star) Dick Cheney (US Vice President) David Bloom (US NBC Correspondent in Iraq) http://wimbledon.open-tennis.com http://en.wikipedia.org/ sounddude.com They all suffered from blood clots.

8. Deep Vein Thrombosis (DVT) Formation of blood clot in deep vein (e.g., leg) The leg can become swollen, hot, red, warm, and painful. healthwithhope.com Complication: The clot can break free and travel into the lungs. How would this affect you? Veinsveinsveins.com

9. Detecting a Pulmonary Embolism http://kierdoestri.blogspot.com/

10. How do doctors treat blood clots? Two treatment options: 1.Medicine (blood thinners) 2.Insertion of medical device to trap the blood clots (IVC filters) Members.tripod.com Greenfield Filter (Boston Scientific) Drugs.com

11. IVC Filters There are many designs. Here are a few. Simon Nitinol Filter lakeridgehealth.on.ca Gunther Tulip Filter En.wikipedia.org Celect filter Cookmedical.com Optease Filter Cordis Corporation G2 Express Filter Bard PV

12. How can computational scientists help? Computational scientists can run simulations and advise vascular surgeons on: – selection of the appropriate IVC filter – placement of the IVC filter. These are patient-specific choices to make. Why do you think the choice of IVC filter and its placement should depend upon the patient?

13. Simulation Ingredients Patient medical data (CT scans)  model of patient veins and blood clots Model of IVC filter (created via computer-aided design) Equations for blood flow Simulate the blood flow in the vein with the IVC filter present

14. IVC Filter Simulations The goal is to simulate (on the computer) the effect of placing a particular IVC filter in the vein of a given patient. Repeat the simulation with different IVC filters and different placements of the IVC filters. Choose the IVC filter and placement that is best for the patient.

15. Hydrocephalus

16. What is hydrocephalus? A build-up of excess cerebrospinal fluid in the head. The ventricles in the brain enlarge. LucinaFoundation.org childrenshospitalblog.org

17. MRI Images of the Brain Which column of images are for the normal brain? Which column of images are for the hydrocephalic brain? MentalHelp.net

18. Treatment of Hydrocephalus Shunts: Remove excess fluid from the brain and transport it to a re-adsorption site Ventriculostomy: Surgical cut made to create hole to drain fluid Nhfonline.orghttp://imannooor.wordpress.com

19. How can computational scientists help? Perform mathematical modeling of the brain and fluid growth. Create computational models of the brain. Perform simulations to determine how to control the settings on the shunts for optimal treatment of hydrocephalus.

20. Computational Tool: Mesh Generation

21. Geometric Modeling via Mesh Generation Geometric models must be created for the IVC filter blood flow simulation and for the hydrocephalus simulation. The models are created by the generation of meshes on the 3D objects.

22. What is a Mesh? To simulate blood flow the vein with the IVC filter present, the vein and filter must be represented by a geometric model. This model is represented as a mesh. A mesh is a collection of vertices and elements with certain properties.

23. Examples of Meshes nitrc.org Zhang et al. ETLab at UAB

24. Dynamic Mesh Generation For applications which move (e.g., insertion of an IVC filter into a deforming vein, the growing hydrocephalic brain) the mesh must be updated in response to the deformations. This is necessary to keep the mesh a valid approximation of the geometry.

25. Beating Heart Simulation Canine ventricles (surface mesh)Canine ventricles (volume mesh) Joint work with Stephen Vavasis, University of Waterloo

26. Some Non-Biomedical Meshing Applications anaxsoft.com msc.commas.uni-stuttgart.de Truegrid.com http://visionair.ge.imati.cnr.it:8080/ St-Cyr, Jablonowski et al., MWR 2008)

27. Summary There are many opportunities for computational scientists to aid doctors. Mesh generation is an important tool for computational biomedical science. Its use extends far beyond computational biomedical science to other areas of engineering and science.

28. IVC Filter Project Participants Current Participants: Suzanne Shontz (PI, CSE) Shankar Prasad Sastry Jibum Kim Keefe Manning (Co-PI, BioE) Michael Navitsky Jason Nanna Matthew Scanlon Frank Lynch, M.D. (Co-PI, HMC) Brent Craven (Co-PI, ARL) Former Participants: Michael Singer (LLNL) Richard Medvitz (ARL) Evan Ford (ARL) Bryan Kraweic (ARL) Thap Panitanarak (PSU) Joseph Pearson (PSU)

29. Hydrocephalus Project Participants Participants: Suzanne Shontz (CSE) Corina Drapaca (ESM) Jeonghyung Park Future collaborations are planned with: Steven Schiff (ESM) and Qian Wang (Mech Eng).